Hacienda Dental, Inc

Primary specialty

DentistTaxonomy code 122300000X

License

24840 Issued in CA

Legal business name

HACIENDA DENTAL, INC

Practice address

5674 Stoneridge Dr
Suite 111
Pleasanton, CA 94588-8500

Phone

(925) 734-0104

Fax

(924) 734-0489

NPI assigned

Sep 17, 2008

Last updated

Sep 17, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Wilson Myers Jr., D.D.SNPI 1356467955

Title

Owner/Doctor

Phone

(925) 734-0104

Specialties & licenses 1

Addresses

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Nirup Reddy and Bortay Dehnadi D.D.S, Inc.

  • Dentist
  • Bakersfield, CA
  • NPI 1407380207
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wilson Myers Jr., DDS

  • General Practice Dentistry
  • Pleasanton, CA
  • NPI 1356467955
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1619126398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5674 STONERIDGE DR",
            "address_2": "SUITE 111",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888500",
            "telephone_number": "925-734-0104",
            "fax_number": "924-734-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5674 STONERIDGE DR",
            "address_2": "SUITE 111",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888500",
            "telephone_number": "925-734-0104",
            "fax_number": "924-734-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACIENDA DENTAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "WILSON",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "925-734-0104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "24840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nishkala Gutta, MD
• Susan Longworth Guzzo, PSY.D.
• Michael Christopher Gynn, MD
• Tom Ha, D.M.D
• Kathryn M Haaland
• Hacienda Outpatient Surgery Center, LLC (Hacienda Surgery Center)
• Hacienda Park Optometry, Inc
• Hacienda Surgery Center, LLC
• Nazila Haghdan
• Haig Minassian MD a Professional Corporation

• Dentist in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.